中医鼻病序贯疗法联合功能性内镜鼻窦手术治疗慢性鼻-鼻窦炎的临床研究  

Clinical study and long-term effect evaluation of sequential therapy combined with functional endoscopic sinus surgery for chronic rhinosinusitis

作　　者：赵莹莹[1] 孙书臣[2] 刘娇媚[1] 汪玉娇[1] 叶晓丽 ZHAO Ying-ying;SUN Shu-chen;LIU Jiao-mei;WANG Yu-jiao;Ye Xiao-li(Department of ENT,Guang′anmen Hospital(South Area),China Academy of Chinese Medical Sciences,Beijing 102600;Department of ENT,Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053;Department of ENT,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102)

机构地区：[1]中国中医科学院广安门医院南区耳鼻喉科,北京102600 [2]中国中医科学院广安门医院耳鼻喉科,北京100053 [3]中国中医科学院望京医院耳鼻喉科,北京100102

出　　处：《世界中西医结合杂志》2020年第4期674-677,共4页World Journal of Integrated Traditional and Western Medicine

摘　　要：目的观察中医鼻病序贯疗法联合功能性内镜鼻窦手术治疗慢性鼻-鼻窦炎的临床疗效。方法选取2015年1月—2017年1月收治的140例慢性鼻-鼻窦炎患者,按照随机对照的原则,将其分为对照组和治疗组各70例,治疗过程中对照组脱落4例,剔除3例。治疗组脱落5例,剔除3例。最后共统计125例,对照组63例,治疗组62例。对照组采用功能性内镜鼻窦手术治疗和围术期综合药物治疗,治疗3个月。治疗组在对照组的基础上联合孙氏序贯疗法,连续3个月。对两组患者进行中医证候、SNOT-20评分量表评分,检测鼻黏膜纤毛传输速率(MTR),评价疗效。结果治疗后两组慢性鼻-鼻窦炎患者中医证候评分均低于治疗前,差异有统计学意义(P<0.05);且治疗组中医证候评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组慢性鼻-鼻窦炎患者SNOT-20各项评分与治疗前比较均降低,差异有统计学意义(P<0.05);且治疗组SNOT-20各项评分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组慢性鼻-鼻窦炎患者MTR与治疗前比较均升高,差异有统计学意义(P<0.05);且治疗组MTR高于对照组,差异有统计学意义(P<0.05)。治疗后治疗组有效率为95.16%高于对照组的79.37%,差异有统计学意义(χ2=6.986,P<0.05)。结论采用中医鼻病序贯疗法联合功能性内镜鼻窦手术治疗慢性鼻-鼻窦炎患者,能够明显改善症状及体征,促进鼻黏膜上皮化,远期效果好,无不良反应,值得临床推广。Objective To evaluate the effect of sequential therapy combined with functional endoscopic sinus surgery in treating chronic rhinosinusitis(CRS).Methods A total of 140 patients with CRS admitted to our hospital from January,2015 to January,2017 were included and randomized into the control group and the treatment group(70 patients per group).During the treatment,there were four dropouts and three cases of withdrawal in the control group and five dropouts and three cases of withdrawal.At the end of the study,there were 125 cases,including 63 cases in the control group and 62 cases in the treatment group.The control group was treated with functional endoscopic sinus surgery and perioperative comprehensive drug treatment for 3 months.The observation group was given Sun′s sequential therapy on the basis of the control group for 3 months.The TCM syndrome score,Sino-Nasal Outcome Test-20(SNOT-20),and nasal mucociliary transport rate(MTR)were applied to evaluate the effect.Results After treatment,the TCM syndrome score in both groups decreased,with statistical significance(P<0.05);and the treatment group had lower score than the control group,with statistical significance(P<0.05).After treatment,SNOT-20 scores in both groups decreased,with statistical significance(P<0.05);and the treatment group had lower scores than the control group,with statistical significance(P<0.05).MTR in both groups increased,with statistical significance(P<0.05);and the treatment group was higher than the control group,with statistical significance(P<0.05).The effective rate in the observation group was 95.16%,which was higher than that(79.37%)in the control group(χ2=6.986,P<0.05).Conclusion The sequential therapy combined with functional endoscopic sinus surgery for chronic rhinosinusitis can significantly relieve the symptoms and signs,promotethe epithelialization of nasal mucosa,with a good long-term effect without adverse reactions,which is worthy of clinical promotion.

关 键 词：中医鼻病序贯疗法 功能性内镜鼻窦手术 慢性鼻-鼻窦炎 远期疗效 

分 类 号：R765.41[医药卫生—耳鼻咽喉科] R765.21[医药卫生—临床医学]